In the last month, three cases of tuberculosis have been referred to the health department. Which of the following is the priority information for the community health nurse to obtain from each client?

Choice A reason: You should avoid sexual contact until therapy is complete. This is to prevent the transmission of the infection to others, and to avoid reinfection or complications. The usual treatment for chlamydia is a single dose of an antibiotic, such as azithromycin or doxycycline. You should abstain from sexual activity for at least 7 days after taking the medication.

Choice B reason: Notify anyone with whom you have had sexual contact over the past 2 months. This is to inform them of their possible exposure to the infection, and to encourage them to get tested and treated if necessary. Chlamydia is a sexually transmitted infection that can cause pelvic inflammatory disease, infertility, ectopic pregnancy, and neonatal complications. It can also increase the risk of acquiring or transmitting other STIs, such as HIV.

Choice C reason: You will need to take an antiviral medication for 30 days. This is not a correct information that the nurse should include in the teaching. Chlamydia is a bacterial infection, not a viral infection. Antiviral medications are not effective against chlamydia, and are not indicated for its treatment.

Choice D reason: Once you complete treatment, you will have an acquired immunity against chlamydia. This is not a correct information that the nurse should include in the teaching. Chlamydia does not confer immunity, and you can get infected again if you are exposed to the bacteria. You should get tested for chlamydia at least once a year, or more often if you have multiple or new sexual partners.

Choice E reason: You might experience painful urination until the infection has resolved. This is a correct information that the nurse should include in the teaching. Chlamydia can cause inflammation and irritation of the urethra, which can result in dysuria, or painful or difficult urination. Other symptoms of chlamydia may include abnormal vaginal or penile discharge, lower abdominal pain, bleeding between periods, or pain during sex. However, some people may not have any symptoms, and may not know they are infected. Therefore, it is important to get tested regularly and to use condoms to prevent the spread of the infection.

Choice A reason: A fee-for-service health care insurance program is not a payment structure of a health maintenance organization. In a fee-for-service program, the client pays a premium to the insurer, and the insurer pays the provider for each service rendered, regardless of the outcome or quality of care.

Choice B reason: A fixed sum payment for the client on a monthly or yearly basis is a payment structure of a health maintenance organization. In this structure, the provider receives a set amount of money per client per period of time, regardless of the number or type of services provided. This encourages the provider to deliver preventive and primary care, and to avoid unnecessary or costly procedures.

Choice C reason: A percentage of the total costs for each service rendered by the provider is not a payment structure of a health maintenance organization. This is a type of cost-sharing arrangement, where the client pays a portion of the expenses and the insurer pays the rest. This may result in higher out-of-pocket costs for the client and higher utilization of services by the provider.

Choice D reason: A predetermined percentage of the cost of services is not a payment structure of a health maintenance organization. This is a type of discounted fee-for-service arrangement, where the provider agrees to accept a lower fee than the usual charge for each service. This may reduce the costs for the insurer, but not necessarily for the client or the provider.